is a Dental Clinic in Nikolai, Alaska. This organization is also known as sub part of Southcentral Foundation. It is located at 9105 Airport Drive, Nikolai, AK and its contact number is 907-293-2328. The authorized person for is Ronald Lee Olsen
who is Executive Vice President Finance of the clinic and their contact number is 907-729-4939. The primary license number for is 20467 (General Practice) in Alaska. Clinic caters to patients of all ages for their dental care needs. Dentists at the clinic are responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Clinic Profile:
Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
Name:
Specialization:
General Practice Dentistry
Clinic Address:
9105 Airport Drive, Nikolai, Alaska, 99691
Phone:
907-293-2328
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
Name:
Ronald Lee Olsen
Position:
Executive Vice President Finance
Contact Number:
907-729-4939
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for clinic are as mentioned below.
NPI Number:
1124575022
Parent Organization:
Southcentral Foundation
NPI Enumeration Date:
08 Sep, 2016
NPI Last Update On:
01 Sep, 2023
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for are as mentioned below.
Specialization
License Number
State
Status
General Practice
20467
Alaska
Primary
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
Identifier
Type
State
Issuer
1654551
Medicaid
Alaska
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
Address:
Po Box 35151, Seattle, Washington
Zip:
98124-5151
Phone Number:
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Patients can reach at 9105 Airport Drive, Nikolai, Alaska or can call to book an appointment on 907-293-2328. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 February, 2025.